*amounts rounded, data as of Dec. 31, 2022
Amount invested in Northwest Oregon community-based organizations in 2022
Number of members who received care coordination services in 2022 through our Regional Care Team
Amount our housing impact fund has invested to increase affordable housing in Northwest Oregon since 2020**
**Funds provided by Columbia Pacific CCO and its Clatsop County risk-share participants, Providence Seaside Hospital, Columbia Memorial Hospital and Clatsop Behavioral Healthcare
How would our communities be different if everyone had a fair opportunity to be as healthy as possible? We believe our members and community leaders who work directly with people experiencing hunger, housing insecurity and other inequities know best when it comes to answering this question.
That’s why we depend on our Community Advisory Councils to help us work toward health equity. In 2022, our advisory councils continued their years-long deep dive into health equity, drawing on their experiences to shed light on inequities in our communities and identify potential solutions.
Our advisory councils began their deep dive into health equity in early 2020, amid the national reckoning over racial injustice and the onset of the COVID-19 pandemic. That year, council members worked to draft health equity vision statements for each of the counties we serve, describing what they’d like to see in their communities and how they’ll work to get there.
“During the protests over the killing of George Floyd and the early days of the pandemic – which had a disparate impact on our rural communities – our advisory councils decided to revisit the issue of health equity. Those discussions led them to articulate what it means for them to be engaged in health equity work,” recalled Heather Oberst, Community Engagement Manager.
In 2021, as the pandemic wore on, our advisory councils took a hard look at some of the most-profound health disparities in our region and proposed ways to address them. Topics included low COVID-19 vaccination rates among certain groups and the systemic issues, such as language barriers, that contributed to vaccine inequity.
“We were able to take feedback from our advisory councils to our community partners to offer resources and help to alleviate some of the stress our members and social services and health care organizations were experiencing at the time,” explained Oberst.
In 2022, our advisory councils reviewed the health equity statements tied to each strategic goal in our 2020-2024 Regional Health Improvement Plan and worked to put those statements in their own words. As part of that process, they identified which groups face the biggest barriers to housing, trauma informed care, suicide prevention services, mental health care, substance use treatment and social services. They also envisioned how the communities we serve might be different if the playing field were level.
Here's a glimpse of what they had to say:
“Human dignity is not defined by documentation status, income, culture, background ... and we all deserve housing and health.”
“People who are experiencing homelessness or need mental health supports are still people. They should be treated with dignity.”
“Support social connections for seniors and disabled [people] to ensure isolation and loneliness are not overwhelming factors that can lead to depression and helplessness.”
For Anita Redheart, an OHP member who serves on our Tillamook Community Advisory Council, the experience has helped her to feel seen and heard.
For many years, “I never knew how to voice that I didn’t think I was getting good care, enough care or quick-enough care,” said Redheart, who has spent most of her life in Tillamook and has deep family ties there. According to Redheart, she is also an enrolled member of Citizen Potawatomi Nation of Oklahoma and a local advocate for Native American rights and cancer support and connection.
As member of our Tillamook advisory council, Redheart has been a voice for friends and neighbors who struggle to put food on the table, to get off the streets, to rebuild their lives after incarceration or to figure out how to find help with basic needs.
“Everyone seems thrilled about getting all these different ideas from the advisory council members. That’s such a comforting feeling to somebody that has been ignored for what seems like forever. I consider it an honor to be part of this group,” said Redheart, who was once houseless.
Interested in learning more about health equity? Read this article by the Robert Wood Johnson Foundation.
Oregon’s housing crisis continued to make headlines over the past year. To us, it is hardly news. Ever since we completed our 2020-2024 Regional Health Improvement Plan – in partnership and with oversight from our Community Advisory Councils – we’ve been working to address the housing crisis in our region.
Since 2020, the Columbia Pacific CCO Regional Housing Impact Fund has invested $3.5 million to increase affordable housing in Tillamook, Columbia and Clatsop counties. Funds were provided by Columbia Pacific and its Clatsop County risk-share participants. And we’re not finished yet.
The housing crisis is less visible in rural Northwest Oregon than it is in some large metro areas, but it’s no less acute.
Even before the pandemic worsened inequities in our region, Clatsop County had the highest per capita rate of houselessness of all Oregon counties, with more than 17 houseless people for every 1,000 residents, according to a 2019 study commissioned by the county and several other municipalities. Tillamook County had the next-highest per capita rate, with nearly nine houseless people for every 1,000 residents. By comparison, on a statewide basis there were 3.4 houseless people for every 1,000 residents.
How did we get here? In Clatsop County, the proliferation of short-term vacation rentals reduced an already constrained supply of housing, pushing up rents for what is left on the market. And throughout our region, abundant wetlands and floodplain areas result in a scarcity of centrally located parcels that are suitable for development.
“The natural environment is one of the things that makes living in these counties wonderful, but it also makes it more challenging to build,” said Elissa Gertler, Executive Director of the Northwest Oregon Housing Authority, which works to provide safe, affordable housing for low-income residents of Clatsop, Columbia and Tillamook counties.
Fortunately, we are seeing a growing level of grassroots activity surrounding affordable housing. More than 200 people turned out for the December 2022 North Coast Housing Summit, which we co-sponsored. They included government officials, developers, financiers, and others who play a direct role in creating affordable housing.
“The momentum around housing solutions has continued to grow now that people know about our housing work. We’re involved in a lot of local conversations about affordable housing,” said Leslie Ford, Columbia Pacific’s Housing Strategy and Development Advisor.
Local organizations are not only talking about the issue but making substantial financial commitments along with us.
Over the last two years, three of Clatsop County's largest health care providers (Providence Seaside Hospital, Columbia Memorial Hospital and Clatsop Behavioral Healthcare) have collectively dedicated nearly $2.9 million to an affordable housing fund. So far, they’ve awarded grants totaling nearly $1.9 million, including $1 million (split between two grants) to projects that will create affordable housing in Astoria for seniors, people with disabilities and others.
All three organizations participate in a risk-sharing agreement with Columbia Pacific and have dedicated most of their earnings from that agreement to their housing fund. The agreement is one way Columbia Pacific is working with partners to improve community health. Earnings from the agreement are the result of cost savings from effective care management (like care coordination services) that results in fewer hospital visits and better health.
We’ve supported the housing work of our risk-share partners by contributing our time and expertise. We use our housing investments platform to vet applications for projects in Clatsop County and make grant recommendations to our risk-share partners.
“Affordable housing not only helps to improve the quality of life and health of our members but benefits everyone in the communities we serve,” said Ford. “By supporting our risk-share partners and investing through our Regional Housing Impact Fund, we’re helping to make our communities stronger and healthier.”
The housing crisis has hit our region in a multitude of ways. Among other things, it has made it harder for employers, including health care providers, to recruit workers from outside the region.
Pam Cooper, Director of Finance for Providence Seaside Hospital, says the hospital has difficulty recruiting doctors, nurses and other health care providers because the few rental homes that are available locally are usually too expensive for these professionals. It is even harder for the hospital to attract lower-wage workers, like environmental and food-service workers, from outside the region.
“Health care workers often have student loans, which makes it very difficult for them to afford rental homes in our area,” said Cooper, who has cultivated relationships with local landlords in order to provide transitional housing, when necessary, to newly hired doctors, therapists, nurses and critical temporary staff.
Little by little, the situation on the ground is improving. In June 2022, we celebrated the groundbreaking of Trillium House at Chelsea Gardens, a 42-unit affordable apartment project in Warrenton. In 2020, our Regional Housing Impact Fund awarded a $400,000 grant to the project, which will be owned and operated by the Northwest Oregon Housing Authority, in partnership with Northwest Housing Alternatives. The grant was the first ever from our housing fund.
When it opens in 2023, Trillium House at Chelsea Gardens will offer one-, two- and three-bedroom apartments that are priced to be affordable to people making less than 60 percent of area median income. Five units will be set aside for clients of Clatsop Behavioral Healthcare, and the agency will provide on-site support to those clients. In addition, Clatsop Community Action will support all residents on an as-needed basis, helping them to avoid eviction, access food and energy assistance and address other needs. Six units will also be set aside for agricultural workers.
“Trillium House at Chelsea Gardens represents the very best of our region. It demonstrates how we pull together to solve our biggest challenges,” said Gertler of the Northwest Oregon Housing Authority.
Trauma informed care and community resilience have long been priorities for our Community Advisory Councils and many organizations in our service region. And it’s not hard to see why.
Adverse childhood experiences (ACEs) – potentially traumatic events during childhood – are linked to chronic health problems, mental illness and substance use and other long-term problems. Research shows that adults living in parts of Northwest Oregon have relatively high rates of ACEs. But there is hope. With our support, dozens of community-based organizations are working together to address childhood trauma and increase resilience.
In April 2022, the Resilient Clatsop County network and the Columbia County Childhood Trauma Informed Network celebrated their one-year anniversaries.
The trauma informed care networks are made up of a diverse group of organizations, including school districts, health care providers, government entities and nonprofits.
By sharing information, adopting best practices and learning together, members of the networks are working to reduce adverse childhood experiences, promote the use of trauma informed practices across sectors and services and build resilience in children and families at the local level. The idea is that by working together, they can have a greater impact than by working alone.
“Research shows that when caregivers provide physically and emotionally safe environments for children and teach them how to be resilient, the negative effects of adverse childhood experiences can be reduced. Our brains are plastic. Our bodies want to heal,” said Angel Escobedo Sr., a Program Development Specialist who was hired by Columbia Pacific in 2018 to provide backbone support to the then-emerging networks.
What are adverse childhood experiences? They include abuse or neglect, witnessing violence at home or in your community, or growing up in a household where a parent is not able to be fully present for their child because of mental illness, substance use, incarceration or other factors.
“In health care, we’re seeing that people with higher numbers of unaddressed adverse childhood experiences are at greater risk for developing health and social problems. But when children have safe environments to process trauma, the long-term impacts can be reduced,” said Escobedo, who is also a dad of three young sons.
“As a parent, I know how important community supports are to family health,” he added.
How are the networks making an impact?
Both networks, for instance, have prioritized the Handle-with-Care model as a simple and effective step to help kids get the support they need after experiencing trauma. Handle with Care helps schools and child care providers identify kids who might need extra support following a traumatic event, such as exposure to domestic violence at home.
Here’s how it works: When law enforcement encounters a child at the scene of a traumatic event, the child’s name and three words, “handle with care,” are communicated to that child’s school before the start of the next school day. The information empowers teachers and other staff to offer support, rather than discipline a child who may be acting out. Teachers, for instance, may provide extra help with coursework, refer a child to the school counselor, provide extra time to complete assignments or reschedule exams.
In addition to Handle-with-Care initiative, both networks have rolled out a training and capacity-building process, with the support of Trauma Informed Oregon. The process helps member organizations adopt trauma informed approaches to care and services. The first trauma-informed care training took place in April 2022, followed by two technical follow-up conversations in sector workgroups.
How are the networks tracking their impact?
Both are working with community partners to track and measure specific areas of impact. For instance, the Columbia County Childhood Trauma Informed Network tracks such data as reports of child abuse, the percentage of children who received dental care or attended well-child visits, school absenteeism, access to childcare and food insecurity at the county level.
“From my perspective, trauma informed care is about understanding where people are coming from: In other words, understanding how their life experiences contribute to how they deal with the world around them,” said Todd Jacobson, Executive Director of Columbia Community Mental Health.
Columbia Community Mental Health is the behavioral health provider for Columbia County and a member of the Columbia County Childhood Trauma Informed Network.
Participating in network meetings and workshops has helped the agency prioritize a trauma informed approach to providing care and engaging with its own employees, said Jacobson, a member of the network’s steering committee.
“Not only do we try to be trauma informed in how we provide services to our clients, but also in how we operate as an organization,” he said. The Columbia County Childhood Trauma Informed Network “helps us keep trauma and trauma-informed care at the forefront of our discussions.”
Interested in learning more about the work of the Resilient Clatsop County network and the Columbia County Childhood Trauma Informed Network? Visit their websites:
We are a nonprofit community benefit company serving more than 33,000 Oregon Health Plan members.
*Clinical Investments do not include distributions from risk-sharing agreements
Note: dollar amounts rounded
Nancy Avery, Board Chair
ODS Community Dental
Jonathan Betlinski, MD
Director, Division of Public Psychiatry
NW Rides Brokerage Manager
Tillamook County Transportation District
Chief Financial Officer
Providence Seaside Hospital
Columbia Health Services
Medical Services Compliance Officer
Columbia River Fire & Rescue
Eric C. Hunter
President and Chief Executive Officer
Monica D. Martinez
Vice President/General Counsel, Legal and Regulatory Affairs
Clatsop Community Action
Tillamook County Community Health Centers
Joe Skariah, DO
Adventist Health Tillamook
Chief Operating Officer
Columbia Memorial Hospital